Depressive Symptoms in Relation to Physical Health and Functioning in the Elderly

Abstract

The associations between depressive symptoms and functional disability and chronic conditions are examined in an elderly cohort of 2,806 noninstitutionalized men and women living in New Haven, Connecticut who were interviewed in 1982 as a part of the Yale Health and Aging Project. The aim is to explore several potential sources of invalidity in using the Center for Epidemiologic Studies-Depression scale (CES-D) to measure depressive symptoms in elderly populations. In particular, the authors are concerned with the possibility that prevalent physical illnesses and disabilities may cause the older person to report many somatic complaints, a major component of most measures of depressive symptomatology, and thereby inflate his or her CES-D score. Mean CES-D scores are 4.86 for those without any disabilities and range to 13.51 for those with major functional disabilities. However, physical disability is significantly associated with virtually every item on the CES-D scale not just those somatically-oriented items. The addition of functional disability to a multivariate model including age subfactor analysis of responses from this elderly sample produces results almost identical to those reported by earlier investigators who studied younger and middle-aged adults. The authors conclude that physical disabilities among the elderly do not appear to be a major threat to the validity of the CES-D scale and that the strong associations between physical and mental health should be rigorously investigated.

Physical health and the onset and persistence of depression in older adults: an eight-wave prospective community-based study

“…Physical illness has long been recognized to be one of the most important risk factors for depression in older adults (Berkman et al 1986 ;Kennedy et al 1989 ;Prince et al 1997). Indeed, this dominant role of physical illness may be one of the most significant differences between late-life depression and depression in younger adults.…”

“…The total CES-D score ranges from 0 to 60. A score of 16 has generally been used as indicative for clinically relevant depressive syndromes (Berkman et al 1986). The psychometric properties of the scale were found to be good in older populations (Radloff & Teri, 1986 ;Beekman et al 1994), and in a number of studies the overlap with symptoms of physical illness has been shown to be limited (Berkman et al 1986 ;Foelker & Schewchuk, 1992).…”

“…In the literature much emphasis has been laid on the relationship between physical health and depression. Physical health problems such as chronic limiting diseases, which are frequently encountered in old age, are often shown to be closely related to depression in older adults (Berkman et al 1986 ;Kennedy et al 1989 ;. It has even been suggested that poor health overwhelms the impact of other risk factors of depression in old age (Kennedy et al 1989 ;Prince et al 1997).…”

Workers' perceptions of how jobs affect health: A social ecological perspective.

“…Thus, it seems likely that self-reported effects of job on health are measuring a slightly different construct than job satisfaction. relationship between physical and mental health (Cohen & Rodriguez, 1995;Patrick & Erickson, 1993;Ryff & Singer, 1998;Salovey, Rothman, Detweiler, & Steward, 2000), with longitudinal studies finding that mental health predicts subsequent physical health outcomes (Fiscella & Franks, 1997;Levanthal, Hansell, Diefenbach, Leventhal, & Glass, 1996;Penninx et al, 1998) and physical illness predicts psychological well-being (Berkman et al, 1986;Wickrama, Lorenz, Conger, Matthews, & Elder, 1997). Thus, the effects of work on mental and physical health are also likely to be inextricably linked.…”

Loop analysis of causal feedback in epidemiology: An illustration relating to urban neighborhoods and resident depressive experiences

“…This article deemphasizes the mathematical theory of loop analysis published elsewhere (Levins, 1974;Puccia and Levins, 1986;Dambacher, et al, 2002;Justus, 2005), and instead guides readers into its application and interpretation. This research is informed by results of an unpublished analysis (manuscript, Dinno, et al) of observed depressive symptomatology over a course of 13 years in a population of 2812 individuals aged 65 and older in New Haven, Connecticut, (Berkman et al, 1986) which were related to spatially detailed representations of building vacancy produced by the annual New Haven Fire Department vacant building census and the New Haven City Plan's GIS database of real property. Neighborhood vacancy was found to strongly explain variation in depressive symptom scores, after controlling for individual factors including economic impoverishment and individual proximity to vacant buildings.…”